MSK: Pseudogout: Free MSRA Podcast

🎙️ MSRA DEEP DIVE PODCAST – Pseudogout (CPPD)Your shortcut to mastering crystal arthritis for the MSRA🧠 Key Learning Points📌 Definition• Pseudogout (Calcium Pyrophosphate Deposition Disease/CPPD) is a crystal arthropathy caused by the deposition of calcium pyrophosphate dihydrate crystals in the joints, leading to acute inflammation.• Mnemonic: CPPD = Calcium Pyrophosphate Precipitates in the joint.📌 Causes & Risk Factors• Ageing: Most common in those over 60• Joint trauma or previous surgery• Metabolic conditions:HyperparathyroidismHaemochromatosisHypomagnesaemiaHypophosphatasia• Family history/genetic predisposition• Mnemonic for metabolic causes in <60s: FJAMH (Family, Joint trauma, Age, Metabolic causes, Haemochromatosis/Hyperparathyroidism)📌 Pathophysiology• Calcium pyrophosphate crystals deposit in joint cartilage and synovium• Crystals trigger intense inflammatory response = pain, swelling, redness, heat• Over time, can cause chronic joint damage📌 Clinical Features• Sudden, severe pain in a joint—most often the knee (but also wrist, shoulder, ankle)• Swelling, redness, warmth• May mimic gout or septic arthritis• Can present as chronic arthritis (esp. in OA patients)• In elderly: more vague or systemic symptoms (malaise, low-grade fever)📌 Differential Diagnoses• Gout (urate crystals—not rhomboid!)• Septic arthritis (urgent to exclude!)• Osteoarthritis• Rheumatoid arthritis• Other crystal arthropathies (hydroxyapatite, etc.)📌 Diagnosis• Joint aspiration:Synovial fluid analysis = rhomboid-shaped, weakly positively birefringent crystals (under polarized light)Rule out infection (Gram stain/culture) and gout (needle-shaped, negatively birefringent crystals)• X-ray:Chondrocalcinosis = linear calcification in cartilage (classic in knees/wrists)• Bloods:Screen for underlying causes (calcium, PTH, magnesium, iron studies, LFTs, TFTs)📌 Management• Acute attacks:NSAIDs (first line)ColchicineIntra-articular steroid injection (for isolated joints)Oral steroids (for polyarticular or severe cases)Joint aspiration (for relief and diagnosis)ICE (symptom relief)• Chronic/recurrent:No proven “disease-modifying” drugs—management is symptomaticTreat underlying causes/metabolic disorders• Mnemonic for acute treatment: ICE NSAID STEROID📌 Complications & Prognosis• Progressive joint damage (secondary OA)• Chronic pain, stiffness, deformity, reduced mobility• Rare: calcification in periarticular tissues, bursitis• Prognosis: chronic but manageable—regular follow-up needed📎 MSRA Pseudogout Revision Resources📝 Revision Notes:https://www.passthemsra.com/topic/pseudogout-revision-notes/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/pseudogout-accordion-qa-notes/🧠 Flashcards:https://www.passthemsra.com/topic/pseudogout-flashcards/🚀 Rapid Quiz:https://www.passthemsra.com/topic/pseudogout-rapid-quiz/🎓 Full Quiz:https://www.passthemsra.com/quizzes/pseudogout/#MSRA #Pseudogout #CPPD #CrystalArthritis #MSRARevisionNotes #MSRAQuiz #MSRAFlashcards #MSRAQandANotes #MSRAAccordions #MSRAExam #Rheumatology #Musculoskeletal #MSRAOnlineRevision